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General NPI Number Information
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NPI Number | 1881295566
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Entity Type | Organization
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Legal Business Name | EPIC POSSIBILITIES AND DEVELOPMENT
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Dates
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Enumeration Date | 11/08/2020
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 204 CUSTER WAY SW STE 101
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City | TUMWATER
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State | WA
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Zip | 98501-3330
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Country | US
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Telephone | 360-480-5388
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Fax |
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Provider Business Mailing Address
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Address Line | 204 CUSTER WAY SW STE 101
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City | TUMWATER
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State | WA
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Zip | 98501-3330
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Country | US
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Telephone | 360-480-5388
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN MALLORY
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Credential | LICSW
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Telephone | 360-480-5388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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